A nurse is reinforcing teaching about ambulating using a cane with a client who has left-sided weakness. Which of the following actions by the client indicates an understanding of the teaching?

Management of clients prescribed opioid analgesics such as Oxycodone requires proactive prevention of predictable adverse effects. Opioids commonly reduce gastrointestinal motility by binding to mu-receptors in the intestinal tract, leading to delayed peristalsis and hard stools. Constipation is one of the most frequent and persistent side effects and does not resolve with continued use. Therefore, bowel regimen medications are typically prescribed concurrently to maintain bowel function and prevent complications.

Rationale:
A. Lorazepam is a benzodiazepine used for anxiety, sedation, or seizure control and is not used to prevent opioid-induced constipation. When combined with oxycodone, it can actually increase the risk of respiratory depression and CNS depression. Therefore, it is not appropriate for preventing common opioid adverse effects.

B. Docusate sodium is a stool softener that helps prevent hard, dry stools by increasing water penetration into the stool mass. It is commonly used alongside opioid therapy to counteract decreased intestinal motility and prevent constipation. Regular use is recommended because opioid-induced constipation is predictable and does not resolve spontaneously.

C. Gabapentin is used for neuropathic pain and seizure disorders and has no effect on bowel motility. It does not prevent gastrointestinal side effects associated with opioids. Additionally, it may cause sedation when combined with oxycodone but does not address constipation risk.

D. Ranitidine is an H2-receptor antagonist used to reduce gastric acid secretion and manage conditions like GERD or peptic ulcers. It does not influence intestinal motility or prevent opioid-induced constipation. Therefore, it is not appropriate for managing this common adverse effect.

Postictal care following a tonic-clonic seizure in a pediatric client focuses on ensuring airway safety, assessing for injury, and supporting recovery after a period of intense neuronal activity. A seizure involves sudden, excessive electrical discharge in the brain, often resulting in loss of consciousness, muscle rigidity, and violent jerking movements. After the seizure stops, the child may be confused, drowsy, and physically vulnerable to trauma sustained during the event. Nursing priorities include airway protection and thorough injury assessment before resuming oral intake or medications.

Rationale:
A. Placing the child in a supine position is not appropriate because it increases the risk of airway obstruction and aspiration, especially in a postictal state where the child may have decreased gag reflex or oral secretions. The recommended position is lateral to maintain airway patency and allow drainage of secretions.

B. Checking the child for oral injuries is a priority because tonic-clonic seizures can cause tongue biting, lacerations, or dental trauma due to involuntary jaw clenching and muscle contractions. Identifying oral injuries is essential to prevent airway compromise, bleeding, or aspiration. This assessment ensures immediate safety and guides further management.

C. Offering clear fluids immediately after a seizure is contraindicated because the child may still have an impaired gag reflex and decreased level of consciousness. This increases the risk of aspiration. Oral intake should be delayed until the child is fully alert and able to swallow safely.

D. Administering oral antiepileptic medication immediately post-seizure is inappropriate because the child may not be fully conscious or able to swallow safely. Additionally, acute post-seizure management does not typically involve immediate oral medication administration unless specifically prescribed and the child is fully alert. Safety and airway protection take priority first.